| NPI | 1184701898 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL DAVID LING Owner/President 763-784-1993 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MN D11532) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2020-08-22 |